| NPI | 1972750065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: OH COA10147NP) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner Neonatal (Licence: MI 4704235374) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2022-07-29 |